HC Quality & Population Health Data Scientist

Description:
• Applies rigorous data science principles and methods to continuous quality improvement and methodical evaluation of HEDIS and Population Health interventions.
• Synthesizes salient data analytics to craft actionable data stories that highlight successes, opportunities, and recommendations for performance improvement by HEDIS measure and subpopulation level.
• Leads data science infrastructure development and automation via SQL, Python, Excel, R, Power BI, and additional tools.
• Leads development of custom analytics to meet regulatory requirements (e.g., Quarterly Business Reports, Annual Reports, RFP).
• Leads rigorous evaluation research into prioritized Medicaid population health interventions from end-to-end (e.g., research design, methodology, analysis, presentation, continuous improvement cycle).
• Leads the development of fact/dimensional data models within Power BI that serve evaluation research effort.
• Leads all data science efforts to continuously monitor our HEDIS and population health performance metrics by applying data-appropriate methodologies and techniques that are rigorous and actionable.
• Leads KPI design, Power BI data modeling, custom algorithms, machine learning, and continuous quality improvement techniques that are guided by sound data science principles and reasoning.
• Leads project management and communication of multi-month, cross-functional data science infrastructure projects.
• Leads in-depth program evaluation analytics to understand the successes and opportunities within the Population Health Management Programs offered by Aetna Better Health of Illinois.
• Leads custom data insights generation for senior leadership and regulatory/accreditation reporting (e.g., Illinois Department of Healthcare and Family Services, NCQA).
• Leads the iterative development of actionable, custom-built Power BI solutions that can be used by frontline staff as well as senior leadership.
• Transforms data intake and reporting efforts that are highly manual into standardized, automated processes that monitor and flag any data validity, accuracy, and completeness issues.
• Effectively communicates data insights to key stakeholders with varying data skills.
• Trains fellow analysts in advanced data science principles, Power BI, SQL, python, R, Hadoop, data visualizations, and other essential data science skills.
• Trains colleagues on how to use and interpret custom-built Power BI solutions.

Requirements:
• At least 5 years of experience within the analytics industry
• At least 3 years of demonstrated healthcare analytics experience within Medicaid/Medicare space
• Advanced knowledge of data science principles and techniques (e.g., inferential statistics, machine learning, algorithms, data modeling, statistical significance testing, forecasting)
• Advanced knowledge of identifying appropriate data science methods based upon the existing data and research questions
• Advanced knowledge of evaluation research, longitudinal trending (e.g., YoY, MoM, QoQ), and population monitoring to demonstrate effectiveness, opportunities, and successes of care management, HEDIS, and population health interventions
• Advanced knowledge of effectively communicating data verbally and visually to data experts as well as non-data experts
• Advanced knowledge of data-appropriate visualization techniques (e.g., bar, line, scatter, boxplot, choropleth map, heatmap, matrix table, decomposition tree, pareto, histograms)
• In-depth experience in RFP work and generating evidence-based data stories for quarterly/monthly reporting
• Advanced knowledge of healthcare data types (e.g., qualitative, quantitative, geospatial)
• Advanced knowledge of SQL and writing SQL code within SQL Server Management Studio
• Advanced knowledge of relational database design including fact-dimensional data modeling
• Advanced knowledge of Power BI (e.g., DAX)
• Advanced knowledge of Microsoft Excel (e.g., formulas, pivot tables/graphs, data slicers, statistical toolkit)
• Advanced knowledge of designing and evaluating KPIs, outcome measures, and other custom-built metrics
• Advanced knowledge of population analytics (e.g., Dx, med econ profiling, SDOH, utilization pattern, CPC, ICD-10, HCPCS) and profiling techniques to gain subpopulation level data insights
• Advanced knowledge of HEDIS and other healthcare data industry standards, issues, and trends
• Advanced knowledge of triangulating salient internal and external data sources to enhance various, fact/dimensional 360° data infrastructure projects
• Ability to curate data to ensure that it is valid, accurate, and complete
• Ability to work efficiently within Microsoft 365 environment that leverages Teams and SharePoint
• Ability to independently plan and execute data analytics requests within cross-functional teams
• Ability to prioritize multiple data requests within a fast-paced environment
• Exceptional attention to detail, critical thinking, and data communication skills
• Exceptional ability to convey complex information in simple, effective ways and craft evidence-based data stories that are clear, concise, and actionable
• Demonstrates a positive attitude and works efficiently to ensure that deadlines are met

Benefits:
• Affordable medical plan options
• 401(k) plan (including matching company contributions)
• Employee stock purchase plan
• No-cost programs for all colleagues including wellness screenings, tobacco cessation and weight management programs, confidential counseling and financial coaching.
• Benefit solutions that address the different needs and preferences of our colleagues including paid time off, flexible work schedules, family leave, dependent care resources, colleague assistance programs, tuition assistance, retiree medical access and many other benefits depending on eligibility.